Bone Cancer Questions

[Guest shannon252]

Lucky has been limping since December and was finally diagnosed with bone cancer in his front left ankle in February (even though I knew all along). My first had bone cancer in her shoulder and it moved very quickly and we lost her within days of diagnosis. Lucky's cancer seems to be a completely different animal. I would like to hear your experiences specifically with cancer in that front ankle. Also, his energy is great and he's eating. His limping had subsided but, has started again. He's kind of an idiot and I'm worried about him breaking the leg. Can it be wrapped or something to help stabilize it? Any suggestions or tips would be appreciated. I am just managing the pain at this point, so please don't turn this into an amputation thread. No need for condolences either, I don't want to cry at work.

 

Thank you!

 

Shannon

[greysmom]

Take a read through the current Osteo Thread in this section of GT. There are several people who are managing pain and providing palliative care, along with several dealing with amputation. The first post has a lot of links and information that will be helpful as well.

 

Osteo is a hideous disease, as you already know. It can progress rapidly or slowly, cause horrible pain quickly or be manageable for many months. Even a dog with cancer in the same spot as yours will have a very different pronosis and reaction.

 

The threat of a fracture in a dog with osteo is always present, even in dogs who go the amp route. Restricting activity, treatment with the bone builder Palladia, pain meds, and adding in other bone building supplements and foods can all contribute to managing his condition.

 

Good luck.

[NeylasMom]

I think it's worth reading through the osteo thread, although maybe not while you're at work if you're trying to avoid tears.

 

Lots of people are getting a lot more time with palliative care only, imo due to catching it much earlier in a lot of cases and in some cases taking advantage of new palliative care options (namely radiation, IV pamidronate, and the use of Gabapentin as an additional pain med). My personal opinion is that the disease progresses rather slowly over some extended period of time (a year or more?) and then at the end, progresses rather exponentially.

 

It sounds like you're not there so you might want to look into those other pain management options. Several people in the osteo thread are having good success with IV pamidronate or the latter in conjunction with radiation. Treatments can be rather costly and are generally done about every month so that can be a prohibiting factor.

 

otherwise, the proper combination of pain meds - typically an NSAID (Deramaxx, that sort of thing), Tramadol, & Gabapentin - is a must. Also, know in what increment you should increase, what max dosages are, and have extra meds on hands so that you can increase as needed with pain without having ot consult your vet (these things always seem to happen over the weekend when vets can't be reached for some reason).

 

I don't think I would wrap the leg, I would just limit exercise - whatever walking he feels up to is fine, but it's your call whether you allow him to run in the house to play or in a yard (I let Neyla play in the house, but did not let her off lead outside). I would also prohibit jumping down off of things so the car and furniture if he has privileges. I built a set of stairs for my bed and a larger platform/step for the couch so that Neyla could continue to use them without having to jump. I just lifted her out of the car because I never got around to building those steps.

[Devotion]

I am so sorry. I have been down this road more times that I can say. Osteo advances differently in each dog. I've had them gone within 5 days and some stay for weeks. I am firm believer in quality of life and won't go to extremes. I've never had luck with the IV pamidronate or radiation and is doubtful I would ever try again.

 

Gabapentin has been used for years for osteo. I think it a long with tramadol is the best combo I've found. Some do good with previcox.

I think you have to decide what you are willing to do and what you are willing to put your dog through.

 

I always go with a day too early is better than a day too late. With that being said, you know your dog best and what they/you can tolerate.

 

I really hope you have much more quality time! Keeping you in my thoughts.

[Guest amberj002]

We are also dealing with osteo in the same location...and also got the diagnosis in February. For us it has progressed really quickly (or much faster than I imagined that it would). For some time I had thought that something seemed off about how she would lay or how she would do certain things, but didn't think anything of it....I kind of thought it was just old age. Then in early February she was standing in the kitchen and I looked down and noticed a lump on her leg about the size of the top part of my thumb...it is now at least the size of a golf ball, which looks huge on her skinny little legs. At the time of diagnosis she wasn't limping at all, within a week she was limping and we increased her meds and that helped for a week before she started limping again. I feel like all we have done is increase pain meds...she has had a really bad couple of days and I fear that the end is near as we are pretty close to maxing out her pain meds and I don't want her to suffer because we don't want to make the decision. When we got her diagnosis we decided we would keep her comfortable and spoil her as much as we could. We have been using Rimadyl (the generic Norcarp), tramadol and gabapentin. And recently added Amantadine, we were told it would take 5 days to a week to see a difference and unfortunately haven't seen any change, in fact I think it has gotten worse but that could have nothing to do with the med. Wishing you the best.

[Guest shannon252]

Oh Amber, I don't want anyone to go through this with me. I am so sorry!

 

Lucky's lump at the ankle is also about the size of a golf ball. I have gone back and forth between limiting his activity and letting him be him. My gut says that I have to let him be the ornery brat boy that he is and hope we don't both pay for it. When we got the diagnosis he was limping horribly and yelping a lot. After I added the Tramadol to the Derramax his limping and yelping almost completely stopped for about two months but, he has just started limping again in the past few days. We also went through about four days where he wasn't eating at all but, that seems to be better now. Oh, did I mention that he also has SEVERE food allergies? Fun stuff! I can't even bribe him with the foods that most people would use to get their dog to eat.

 

Thank you all for the feedback. I'll definitely go take a look at that thread...after I get home. I hadn't logged on here in so long that I kind of forgot how to find my way around.

Edited April 3, 2012 by shannon252

[Guest snakes]

I have posted throughout the OS thread about our adventures with FedX but I will try to summarize it quickly here.

He was diagnosed with IS in his front left radius (wrist) January 2011. I opted for palliative care (pain and quality of life management). We have him on gabapentin (works wonders for him), and carprofen, tramadol we use as needed. His pain seems to be worse on rainy days and very cold weather (under 34degrees) really hurts him. There have been times when he has become rambunctious and stressed the leg quickly resulting in GSOD and bad limping for 2-4weeks. We increase pain meds in this times and go for very very short walks.

When he is feeling well I let him decide the length of walking but limit him to no running and as little jumping as possible (he gets very excited sometimes . There is no good way of wrapping an osteo leg as pressure can cause more pain. I found there really was no good brace as it is a joint and needs to be flexible.

We tried radiation which made his pain worse, others have had more success with it. We do do pamidronate infusions which help his pain A LOT, but they do come to $400/treatment including blood work to check the kidneys and it is a 3-4hr infusion.

We give him a chinese herb mixture, i am lucky our vets practice natural and alternative remedies.

We also do artemisinin which i think helps him, he seems more feisty on the days he receives that I got that info from the yahoo Group on artemisinin.

I did change his food to a higher protein food, but i think amongst everything else it has actually had the least impact for FedX.

 

He is now 15months post diagnosis and still going. There were times that I thought it may be the end but he proved me wrong. It is incredibly stressfull so feel free to ask many and all questions, the osteo thread has info but also very supportive people going through the same thing and we are all doing different treatments.

[GeorgeofNE]

Oh, I'm so sorry. I would think if you get to the stage where the bone is so fragile that it's going to break, it's time to consider that the end has arrived--but that's just my own personal opinion.

 

Best wishes.

[Guest SueG201]

I am so sorry for what you are going thru but I cannot give you info, I lost a 5 yr old to os of the shoulder, and a 9 yr old to os of the back leg, it still pains me to even talk ab out it after all these years. I screamed at God after i lost my second grey to OS, I could not believe that I would have to go thru this again so soon,, my prayers are with you

[Guest shannon252]

Thank you so much. The very worst part of it for me is seeing him with so much energy, being his normal crazy self but, knowing that the end is out there...somewhere. I constantly worry that I won't know it's time when the time comes and I worry about doing something for him that is more about me than it is about him. I don't want to be that person who holds on too long because I can't let go.

 

Susan, there really isn't any way to know when you get to the point that the bone is so fragile it might break. I've seen dogs with osteo break a leg when there were absolutely no symptoms or knowledge that the dog was ill. No limping or anything. One of them was playing happily before the mom left the house and it was broken when she got home.

 

I think I'm pretty much on the right path although I will definitely ask my vet about Gabapentin. This is the first I've heard of it.

[Batmom]

No advice, just asking for you to deliver some scritchies and maybe an ice cream, from time to time, to sweetest boy. I will never forget how much Zema liked him. She didn't like other dogs! But she thought he was just fine. I'm so sorry the two of you are facing a rotten diagnosis.

[KF_in_Georgia]

I think I'm pretty much on the right path although I will definitely ask my vet about Gabapentin. This is the first I've heard of it.

 

According to information from OSU mentioned in the osteo thread, there are indications that gabapentin is most effective in smaller doses given more frequently, rather than larger doses given just once or twice a day. Thus, if your vet is going to prescribe gabapentin, try to get a prescription for 100mg capsules. My pharmacy (a Walgreens) says that gabapentin is available in 100mg and 300mg capsules--i.e., powder-filled capsules that cannot be split. The "splittable" version is a 600mg tablet (which sounds like a bear to split). My vet has okayed a dosage of up to 900mg a day for Sam (63 pounds). At present, we're doing 200mg at a time, usually given three times a day, so we still have room to add more if necessary. (Also, at this dose, I wouldn't be hesitant to add an extra capsule between his regularly-scheduled doses if he were having a bad day.)

 

It takes about 48 hours for gabapentin to build up in the body, and if you start with a big dose, it's likely to make your baby really groggy and unsteady. So start with 100mg at a time, then add more pills as needed.

 

Avoid liquid gabapentin. Your vet probably would know better than to prescribe that form, and your pharmacy should have the sense to question it, but liquid gabapentin is often prescribed for children. For children, it has xylitol to sweeten it, and xylitol is toxic to dogs. (Gabapentin started as a drug to treat epilepsy, which is why it's prescribed for children.)

[Guest shannon252]

Wow! Such great information, thank you!!! Do you give all three then? Derramax, tramadol and gabapentin?

[45MPHK9]

We gave Bee Wiseman Deramaxx, Tramadol, and Gabapentin at the same time. (She started out only on Tramadol. We then added the Deramaxx and then the Gabapentin.) She lived for eight weeks after being diagnosed with osteo. When we saw her limp return after taking all three of those drugs at high doses, we made the decision, with the help of our vet, to release her fom her pain. We were lucky that Burke coud take her to work everyday. We lived in fear of her breaking her leg once we were given the diagnosis.

 

I'm sorry for what you are facing right now. It is a miserable road.

[NeylasMom]

Wow! Such great information, thank you!!! Do you give all three then? Derramax, tramadol and gabapentin?

Yes, all 3 are usually given together. Previcox is an alternative to the Deramaxx. Both are NSAIDS and I believe that both are thought to potentially have some anti-cancer properties as well.

 

My favorite article on palliative care for dogs with osteo: article. Also linked to in first post of osteo thread.

[Guest shannon252]

Is it the cancer study thread that you keep talking about?

[cmc333]

When Gypsy was diagnosed with OS, she had been limping for 4 days only. She already had thyroid cancer and the vet nor I thought amputation would be a good idea. We went the rimadyl, tramadol, gabapentin route.. We only had her for a month and 2 days after the dx. She never had a day again when she didn't limp, even on the maximum doses. She still had her appetite, but she wasn't allowed to play or run. She was pretty consistent with the amount of pain and limping from day to day and then one morning, she looked at me and it was time. You WILL know; you can see it in their eyes. Enjoy all the time you do have and remember, Lucky lives in the day and has no idea what the future holds. So he'll just think that all of a sudden he won the "spoil me rotten" lottery and enjoy every day of being loved and spoiled by you.

 

Connie

[BauersMom]

Is it the cancer study thread that you keep talking about?

 

It's this thread:

http://forum.greytalk.com/index.php/topic/279977-osteo-thread/

[greysandmollie]

Shannon...

 

Sorry for your rotten news...many good wishes that Lucky enjoys lots of quality time with you...

 

Donna

[KF_in_Georgia]

Wow! Such great information, thank you!!! Do you give all three then? Derramax, tramadol and gabapentin?

 

I just wanted to give you all the gabapentin info I could, in case your vet isn't familiar with it. My vet wasn't. I told him what I'd read on Greytalk, he ran out to doublecheck the dosage for a 67-pound greyhound (Sam's lost weight in the last week), and came back in with a written script that was worded the way I needed it. ("1 to 2 capsules by mouth up to three times daily for ancillary pain.") I love my vet.

 

Sam doesn't have osteo, but he has lung cancer, spinal arthritis, and a slightly herniated disk. He gets tramadol, gabapentin, and methocarbamol (a muscle relaxer). He was getting meloxicam as his NSAID, but he started having stomach trouble.

 

P.S. Also ask your vet about Pepcid before his meds to soothe Lucky's stomach.

[countrypaws]

Caesar,11, is our heart dog, our first greyhound, and a happy, happy boy. We discovered a lump on his right rear leg Saturday, had an X-ray Monday and saw an oncologist today. She feels it is osteosarcoma and has been developing for 4-8 weeks. We didn't want to put him through a biopsy procedure.

 

I can't see amputation as an option to make an 11 year old greyhound learn how to walk again in his last months. Call it a quality of life issue. We may try chemotherapy. Our oncologist vet is recommending three week alternating intervals of Adriamycin and Carboplatin. I thought we might do two chemo treatments and take another exray of the tumor in eight weeks to see how it has changed. Treatments are about $550 each. I think two would tell us if we're having any effect.

 

We'd welcome the experiences of those who have gone through this.

 

Larry B.

 

 

 

[Guest shannon252]

Oh my gosh, I don't know if I want to say poor Sam or poor Kathy. I thought the cancer with the food allergies was a lot to deal with.

 

Thanks Donna!

 

Connie, after I lost Lucky's uncle, our animal communicator told me that dogs don't think of death the same way we do and it helped a lot. For now I'm pretty at peace with the situation. I expect that to change.

 

Again I say thank you to everyone for such great information!

[NeylasMom]

Larry, I'm so sorry to hear about Caesar. Again, I would recommend the osteo thread linked to a few posts back. There is at least one dog diagnosed relatively recently who is going the chemo without amputation route.

[Guest sirsmom]

We lost our beloved Sir in 2008 from OS. We did palliative. My vet prescribed only pred. at first and felt if he was "too painfree" he would break the leg by jumping etc. So until I saw more visible discomfort we kept him on the pred. and then deramax kept him comfortable for awhile. When I saw he didn't have a life anymore, we let him go. I'm just so sorry you have to go through this.

[countrypaws]

Well, we're going to try to slow it down with chemo but the disease always wins and we know that. How he is feeling and doing will be our guide. We just felt that his quality of life being 11 and having to start over as a tripod would be too stressful for such a sweet boy. We start chemo Friday. Susie called the vet to schedule the chemo and had to hang up, she was crying too hard. She came outside wher eI was working sobbing and I was sure Caesar had broken his leg. Turns out she just couldn't talk about him to the oncology office.

 

We are beginning a journey we never asked to take, but we will be with him each day. I know he knows how much we love him. He knows things before we do. He's taught us so much.

Edited April 5, 2012 by countrypaws